Community-led mental health promotion for people of color in the United States

Abstract

There are stark racial inequities in mental health in the United States. A statewide minority health agency in the US state of Indiana, sought to find an evidence-based, culturally relevant mental health promotion program for their affiliates after finding a dearth of options appropriately for the communities of color they served. Therefore, the agency led a collaboration with community-based minority health affiliate agencies and two researchers to design, implement, and evaluate a mental health promotion program prioritizing people of color. The first implementation cycle in 2016 yielded a low sample size, so the program was implemented in 2018. A mixed method evaluation assessed participant outcomes and implementation processes. Matched pre, post, and eight-week follow-up assessments measured participant changes in knowledge, attitudes, and behaviors; and usage of skill-building tools. Educator and observer reflection checklists completed at every site for every session and ten semi-structured interviews of educators were triangulated to evaluate implementation processes. Statistically significant improvements showed positive results for participants using tools such as mindful breathing and imagery outside of the program in their everyday lives. Qualitative data further supported these findings with data illustrating patterns of self-reflection and application of program material. Educator and observer data also revealed appreciation for the curriculum, perception of benefit for participants, lack of fidelity, and time management challenges. Results suggest this program warrants further research as a promising practice for community-based, mental health promotion prioritizing people of color to ultimately contribute to reduction in disparities in mental health.